Any other doctors thinking of calling it quits?

[Anonymous]

One of the PPs said that 85% of American are insured and later implied that this means 85% of Americans are happy with their coverage.

Wrong. We found out the hard way that you can have the best insurance out there (a supposedly great PPO that was costing us an arm and a leg), and do all the right things ("save for a rainy day"), and you are still just one medical catastrophe away from bankruptcy.

Our healthcare system is so broken that if you or a family member (in our case, a baby in the NICU) require prolonged intensive care, you'll exceed the lifetime cap on your policy and you will end up having to declare bankruptcy to pay the bills. Can you imagine how horrifying it is to realize that only because your baby died, you actually avoided financial ruin and so are able to feed and house your remaining children?

We found out that this is really common. And it's inhumane. There must be a better way.

[Anonymous]

Isn't the get health insurance from an employer part of the overall problem? Employers like Walmart get around health insurance by only letting workers work PT. And people stay at a job just for the insurance benefits.

[Anonymous]

Anonymous wrote:Isn't the get health insurance from an employer part of the overall problem? Employers like Walmart get around health insurance by only letting workers work PT. And people stay at a job just for the insurance benefits.

I agree the system is really messed up, but I still believe in an employer-based system (with a government safety net for those who can't work, retired, unemployed, etc.). I just really want my employer to have a stake in my health. We spend more time at work than almost anywhere else. My company knows that, so they fund a gym in the building with showers to make it easier for folks to work out, they do a health fair every year, they encourage "walking breaks," and work life balance. My husband's company is even better. They have a clinic in the building which is so convenient, and are always offering things like yoga at work, boot camps, seminars on healthy eating, they really support breastfeeding moms, etc.

If they didn't have a stake, all of these options would disappear because they are not footing the bill.

[Anonymous]

Seems to me that the social contract that doctirs made with the public is over. The set up used to be that you give up 10-15 years of your life and money. You work hard and dedicate yourself. Then pass your boards. In return, doctors are supposed to live a comfortable life. It does not seem so, since so many people think otherwise.

[Anonymous]

"Wrong. We found out the hard way that you can have the best insurance out there (a supposedly great PPO that was costing us an arm and a leg), and do all the right things ("save for a rainy day"), and you are still just one medical catastrophe away from bankruptcy. "

This is so true. We also had a baby in the NICU and the costs were in the hundreds of thousands. We were only saved from disaster by luck. The insurance plan that we were on from my job had a higher lifetime max and better coverage for hospital stays. Prior to this, we had been considerig switching to DH's plan which was actually more expensive but covered more primary care and pediatrician's offices that we preferred. This plan has less coverage for hospital events and a lower max. The only thing that saved us was we had to wait until the next enrollment so we were on the better plan when DD was born.

People have a false sense of security that insurance is an adequate protection. Since your company is the one negotiating the insurance contracts you really have no control when it changes. Who is realistically going to catch a subtle change or be able to change jobs when this happens?

[Anonymous]

"If you are unemployed, aren't you eligible for medicaid? I had to go that route with my first and I thought the coverage was great."

Medicaid eligibility is based not just on your income but your assets as well. You'd have to lose almost everything, including your house, before you'd qualify.

[Anonymous]

OP, I haven't had time to read all the responses. But I know that specialists can make, it seems to me, a lot of money and have a pretty sweet gig going. For example, the ENT that did both of my kid's ears got a ridiculous amount of money for a five minute procedure. And he also was kind, competent and changed all of our lives for the better. Sounds like a satisfying career to me!

[Anonymous]

PP, for some of the lifestyle-oriented, well-paying specialties (like ENT, dermatology, radiology), this can be the case. But those of us who train for 10+ years to take care of actual sick people may be rewarded with long hours, middling pay, and exhaustion while we try to balance all of this with family life.

It was a rude awakening to me that a home organization specialist (who, I might note, I would like to hire because I cannot keep track of everything at home AND my career) makes more money than I do hourly, and I trained for 7 years AFTER medical school to work in critical care. Forget about being a primary care physician...they make even less.

Thankfully I still consider my job quite rewarding, and though I don't really have the option to stop working, would not want to completely quit regardless. What frightens me is that if the system does not improve, who will want to take care of all of us????

[Anonymous]

Why not stop taking insurance? None of my doctors take it. They leave it to me to fight it out with my insurance company about how much they will reimburse me.

Another path is to develop a side practice in an elective procedure or procedures. My DH's uncle did this. His specialty was removing skin cancers (dermatological microsurgery). The HMOs kept paying less and less. He still does those surgeries, but expanded his practice to elective dermatology procedures and is now raking it in. (Too bad he doesn't live closer - could use the family rate on Botox!) My OB also offered laser hair removal, FWIW.

I am not saying the system is great. I was appalled at how little my insurance company paid my OB for delivering my first. It was a harrowing delivery of a preemie followed by lots of complications for me that he had to deal with. He was there, off and on, for over 12 hours. If I billed that time at my rate back then, it would have been about $6,000, but he got less than $3,000. He helped a baby into the world, probably has 10 years more experience than I do, and all I do is write contracts! Until the system gets fixed, it may be worth looking at work arounds.

[Anonymous]

Primary care doctors don't make a great deal, it's true, especially in relation to the years they invest in training. Many specialists, on the other hand, continue to earn very well. This has always been true, of course.

Many other professionals, particularly those with PhDs, earn very little in proportion to their years of training. This too has always been true; think of professors, for example. Yet other PhDs, such as many engineers, earn very well.

OP, one great advantage of medicine as a career is its portability. If you're not otherwise tied to the DC area, I'd look elsewhere for a higher quality of life. If you are tied to DC, I'd look for a federal job, as some PPs have suggested. Good luck.

[Anonymous]

This is when you really know that MONEY IS NOT EVERYTHING PEOPLE!!!!
Welcome to the real world.

[Anonymous]

i have a phd and feel similarly to the op. many. many years of training (while not earning anything) only to yield, in my case, not one job in my field. after three years of looking, i work as a freelance technical writer and do some adjunct teaching. and it sucks, frankly. a lot of people are being very judgmental about the "choices" op made etc. you have to remember--most people are making these choices at about the age of 20. it's hard to really understand the big picture at that age. i started grad school at 22. that was now 12 years ago and the world has a changed a lot since then too. it took a few years for me to realize the long-term impact on my career/quality of life/earning power of getting a phd in the humanities. by that time, i was 26 or so and had invested four years into it. at that point, it seemed ridiculous to drop out, so pushed through for three more years.

these are not the simple, easy, uncomplicated scenarios that some posters are suggesting. if i had the benefit of the life experience and the information about job markets and the economy and work-life balance when i was apply to grad school at age 21, i would have made a different choice.

[Anonymous]

While I feel for people who do not like their health insurance..the reality is that we are moving toward a single payer system that will have rationing--it's a reality that no one wants to discuss. Soo you somday may be a parent in the nicu and told that the chances of your child surviving are slim and that treatment is over and that may well be when the dollar figure is not even close to your max. Or your child may have cancer and you are told that you can have your surgery next year and hope that your child makes it until then. Thousands of people come over from Canada for life saving treatment and there is a reason for this..their healthcare stinks. Now if you are someone who doesn't like to work and pay for insurance then sure it will be better than what you have but for those of us productive people it will be a step down.

[Anonymous]

Anonymous wrote:While I feel for people who do not like their health insurance..the reality is that we are moving toward a single payer system that will have rationing--it's a reality that no one wants to discuss. Soo you somday may be a parent in the nicu and told that the chances of your child surviving are slim and that treatment is over and that may well be when the dollar figure is not even close to your max. Or your child may have cancer and you are told that you can have your surgery next year and hope that your child makes it until then. Thousands of people come over from Canada for life saving treatment and there is a reason for this..their healthcare stinks. Now if you are someone who doesn't like to work and pay for insurance then sure it will be better than what you have but for those of us productive people it will be a step down.

Not necessarily true. In England there are private doctors and hospitals. A friend of mine says she has never set foot in a public hospital. I think her employer may even provide supplemental insurance so she is not out of pocket for everything. From what I have been able to gather, it's just like the docs here who don't take insurance now. I think for a good number of us little will change.

[Anonymous]

Anonymous wrote:

Anonymous wrote:While I feel for people who do not like their health insurance..the reality is that we are moving toward a single payer system that will have rationing--it's a reality that no one wants to discuss. Soo you somday may be a parent in the nicu and told that the chances of your child surviving are slim and that treatment is over and that may well be when the dollar figure is not even close to your max. Or your child may have cancer and you are told that you can have your surgery next year and hope that your child makes it until then. Thousands of people come over from Canada for life saving treatment and there is a reason for this..their healthcare stinks. Now if you are someone who doesn't like to work and pay for insurance then sure it will be better than what you have but for those of us productive people it will be a step down.

Not necessarily true. In England there are private doctors and hospitals. A friend of mine says she has never set foot in a public hospital. I think her employer may even provide supplemental insurance so she is not out of pocket for everything. From what I have been able to gather, it's just like the docs here who don't take insurance now. I think for a good number of us little will change.

When I lived in the UK, I had private insurance, but I still had to use public hospitals. I actually don't know of any private hospitals, other than one in London.